CAJ | 학술논문

目的:考察并分析单纯性肥胖症合并2型糖尿病患者行腹腔镜可调节胃绑带捆扎术后效果.方法:收集自2003年6月~2011年6月间于我院行腹腔镜下胃绑带捆扎术(laparoscopic adjustable gastric banding,LAGB)的肥胖症合并2型糖尿病的患者47例.结果:受试患者的术前体征指标和血常规指标均超出正常水平,餐后2h的血液学指标除高密度脂蛋白胆固醇,其余指标均升高(P<0.05).手术后1周内即开始出现额外体重减轻、体重指数、腰围、臀围的下降,术后2年内体重降低速度较高,术后2年各项指标基本达到稳定,其中额外体重减轻、体重指数、腰围、臀围在2年内降低速度较快,平均额外体重减轻2年达56.4%,平均体重指数由41.6kg/m2降低至28.7kg/m2.空腹血糖和糖化血红蛋白术后1年大部分病例恢复正常,2年基本恢复正常.术后合并症均有不同程度改善.术后出现的并发症经对症治疗均治愈.结论:肥胖症合并2型糖尿病的患者行LAGB后2型糖尿病患者的早期缓解依赖于体重的下降,晚期缓解可能涉及更多因素,LAGB是一种安全、尚有效的手术方式.
목적:고찰병분석단순성비반증합병2형당뇨병환자행복강경가조절위방대곤찰술후효과.방법:수집자2003년6월~2011년6월간우아원행복강경하위방대곤찰술(laparoscopic adjustable gastric banding,LAGB)적비반증합병2형당뇨병적환자47례.결과:수시환자적술전체정지표화혈상규지표균초출정상수평,찬후2h적혈액학지표제고밀도지단백담고순,기여지표균승고(P<0.05).수술후1주내즉개시출현액외체중감경、체중지수、요위、둔위적하강,술후2년내체중강저속도교고,술후2년각항지표기본체도은정,기중액외체중감경、체중지수、요위、둔위재2년내강저속도교쾌,평균액외체중감경2년체56.4%,평균체중지수유41.6kg/m2강저지28.7kg/m2.공복혈당화당화혈홍단백술후1년대부분병례회복정상,2년기본회복정상.술후합병증균유불동정도개선.술후출현적병발증경대증치료균치유.결론:비반증합병2형당뇨병적환자행LAGB후2형당뇨병환자적조기완해의뢰우체중적하강,만기완해가능섭급경다인소,LAGB시일충안전、상유효적수술방식.
Objective:To study and analysis of effect of postoperative follow-up results from 47 cases of simple obesity combined with type 2 diabetes underwent laparoscopic adjustable gastric bandage.Methods:From June 2003 to June 2011,47 cases of simple obesity combined with type 2 diabetes underwent laparoscopic gastric bandage banded gastroplasty(LAGB) in our hospital were enrolled in our study.Results:Physical indicators and bloody indicators of patients were exceeded over the normal ones.Except high-density lipoprotein cholesterol,other bloody indicators increased in 2h after meal (P<0.05).The excess weight loss (EWL),BMI (body mass index),waist circumference,hip circumference reduced since 1 week after surgery to reduce.Many indicators have balanced till 2 years after surgery. The EWL,BMI,waist circumference,hip circumference were highly reduced within 2 years,with EWL reduced to 56.4%,the average BMI decreased to 31.0% from 41.6 kg/m2 before surgery to 28.7 kg/m2.Fasting blood glucose after surgery 1 year was returned to normal.The complications were improved after operative.Postoperative Adverse reactions were cured after symptomatic treatment.Conclusion:For patients of obesity combined with type 2 diabetes mellitus,it depends on the weight loss for curing type 2 diabetes in short time and depends on more factors including weight loss in long term,and it is safe to undergo LAGB.